rs773046204

Variant summary

Our verdict is Likely benign. The variant received -6 ACMG points: 0P and 6B. BP4_ModerateBS2

The NM_020436.5(SALL4):​c.203G>A​(p.Arg68Gln) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000621 in 1,611,502 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 15/22 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R68W) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000033 ( 0 hom., cov: 30)
Exomes 𝑓: 0.000065 ( 0 hom. )

Consequence

SALL4
NM_020436.5 missense

Scores

1
18

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:3

Conservation

PhyloP100: 1.81

Publications

2 publications found
Variant links:
Genes affected
SALL4 (HGNC:15924): (spalt like transcription factor 4) This gene encodes a zinc finger transcription factor thought to play a role in the development of abducens motor neurons. Defects in this gene are a cause of Duane-radial ray syndrome (DRRS). Alternative splicing results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Dec 2015]
SALL4 Gene-Disease associations (from GenCC):
  • Duane-radial ray syndrome
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae), PanelApp Australia
  • Duane retraction syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • IVIC syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Likely_benign. The variant received -6 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.09830722).
BS2
High AC in GnomAd4 at 5 AD gene.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
SALL4NM_020436.5 linkc.203G>A p.Arg68Gln missense_variant Exon 2 of 4 ENST00000217086.9 NP_065169.1 Q9UJQ4-1
SALL4NM_001318031.2 linkc.203G>A p.Arg68Gln missense_variant Exon 2 of 4 NP_001304960.1 Q9UJQ4-2
SALL4XM_047440318.1 linkc.-104G>A 5_prime_UTR_variant Exon 2 of 4 XP_047296274.1

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
SALL4ENST00000217086.9 linkc.203G>A p.Arg68Gln missense_variant Exon 2 of 4 1 NM_020436.5 ENSP00000217086.4 Q9UJQ4-1

Frequencies

GnomAD3 genomes
AF:
0.0000329
AC:
5
AN:
152130
Hom.:
0
Cov.:
30
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000735
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000322
AC:
8
AN:
248360
AF XY:
0.0000371
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000289
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000533
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000651
AC:
95
AN:
1459372
Hom.:
0
Cov.:
35
AF XY:
0.0000634
AC XY:
46
AN XY:
726088
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33480
American (AMR)
AF:
0.0000224
AC:
1
AN:
44722
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
26136
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39700
South Asian (SAS)
AF:
0.0000580
AC:
5
AN:
86256
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
50946
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5768
European-Non Finnish (NFE)
AF:
0.0000782
AC:
87
AN:
1111992
Other (OTH)
AF:
0.0000331
AC:
2
AN:
60372
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.469
Heterozygous variant carriers
0
6
12
18
24
30
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
10
20
30
40
50
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.0000329
AC:
5
AN:
152130
Hom.:
0
Cov.:
30
AF XY:
0.0000404
AC XY:
3
AN XY:
74302
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
41420
American (AMR)
AF:
0.00
AC:
0
AN:
15262
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3472
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5198
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4826
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10610
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.0000735
AC:
5
AN:
68022
Other (OTH)
AF:
0.00
AC:
0
AN:
2092
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.485
Heterozygous variant carriers
0
1
1
2
2
3
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Alfa
AF:
0.0000406
Hom.:
0
Bravo
AF:
0.0000453
ExAC
AF:
0.0000330
AC:
4
EpiCase
AF:
0.0000545
EpiControl
AF:
0.0000593

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:3
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Duane-radial ray syndrome Uncertain:1
Apr 08, 2020
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. Algorithms developed to predict the effect of missense changes on protein structure and function output the following: SIFT: "Tolerated"; PolyPhen-2: "Benign"; Align-GVGD: "Class C0". The glutamine amino acid residue is found in multiple mammalian species, suggesting that this missense change does not adversely affect protein function. These predictions have not been confirmed by published functional studies and their clinical significance is uncertain. This variant has not been reported in the literature in individuals with SALL4-related disease. This variant is present in population databases (rs773046204, ExAC 0.02%). This sequence change replaces arginine with glutamine at codon 68 of the SALL4 protein (p.Arg68Gln). The arginine residue is weakly conserved and there is a small physicochemical difference between arginine and glutamine. -

Inborn genetic diseases Uncertain:1
Jun 07, 2025
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The c.203G>A (p.R68Q) alteration is located in exon 2 (coding exon 2) of the SALL4 gene. This alteration results from a G to A substitution at nucleotide position 203, causing the arginine (R) at amino acid position 68 to be replaced by a glutamine (Q). Based on insufficient or conflicting evidence, the clinical significance of this alteration remains unclear. -

Oculootoradial syndrome;C1623209:Duane-radial ray syndrome Uncertain:1
Mar 21, 2022
Fulgent Genetics, Fulgent Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.086
BayesDel_addAF
Benign
-0.40
T
BayesDel_noAF
Benign
-0.65
CADD
Benign
16
DANN
Uncertain
0.98
DEOGEN2
Benign
0.13
T;.
Eigen
Benign
-0.58
Eigen_PC
Benign
-0.56
FATHMM_MKL
Benign
0.66
D
LIST_S2
Benign
0.19
T;T
M_CAP
Benign
0.0040
T
MetaRNN
Benign
0.098
T;T
MetaSVM
Benign
-1.0
T
MutationAssessor
Benign
1.1
L;L
PhyloP100
1.8
PrimateAI
Benign
0.24
T
PROVEAN
Benign
-0.17
N;N
REVEL
Benign
0.080
Sift
Benign
0.36
T;T
Sift4G
Benign
0.47
T;T
Polyphen
0.019
B;.
Vest4
0.10
MutPred
0.23
Loss of helix (P = 0.0068);Loss of helix (P = 0.0068);
MVP
0.60
MPC
0.39
ClinPred
0.14
T
GERP RS
1.3
Varity_R
0.031
gMVP
0.067
Mutation Taster
=96/4
polymorphism

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

Other links and lift over

dbSNP: rs773046204; hg19: chr20-50408819; COSMIC: COSV108040106; API